Anal Skin Tags: What Causes Them, Can They Be Removed, and When Should You Be Concerned?
Anal skin tags and scarring are common after haemorrhoids, anal fissures and anorectal surgery. While they are often harmless, they can affect hygiene, comfort, confidence and sexual wellbeing. Treatment isn't always about simply removing the skin tag - it’s also important to try and understand why it developed, and address the underlying cause to improve long-term outcomes.
Why do skin tags develop?
It's common to notice changes in the appearance of the anus after anorectal conditions or surgery. These changes may include skin tags, scarring, or alterations in the shape or texture of the skin.
Often, these changes are simply part of the body's natural healing process. Swelling from haemorrhoids can stretch the overlying skin, and inflammation which can occur after fissures, can cause an overgrowth of skin. As swelling settles or wounds heal, excess skin or scar tissue can remain behind.
Common causes include:
Haemorrhoids
Anal fissures
Previous anorectal surgery
Chronic inflammation
Anal abscesses or fistulas
Trauma to the area
Pregnancy
Although these changes are often medically harmless, they can still affect hygiene, comfort and confidence.
Are anal skin tags normal?
Yes.
Anal skin tags are extremely common and are a common reason people see surgeons.
Many skin tags never cause symptoms and don't require treatment. Others become bothersome because of their size, location or the symptoms they cause. It is important to mention that skin tags are almost never harmful, and removal is only required if they bother you.
Before removing a skin tag, it's important to understand why it's there
Patients mostly book an appointment to see a surgeon to have their skin tags removed. Whilst this is reasonable, its also important to consider why the skin tag developed in the first place.
For example, a painful skin tag is often associated with an underlying anal fissure. Simply removing the tag without treating the fissure may result in poor healing, persistent pain and recurrence of the skin tag.
Similarly, skin tags commonly develop after haemorrhoids. If the underlying haemorrhoids are still causing problems, removing the skin tag alone may not provide the best long-term result. In fact quite frequently, the skin tag is associated with residual haemorrhoid tissue and it is impossible to remove the skin tag without removing the haemorrhoid.
A thorough assessment helps determine whether the skin tag itself is the problem, or whether it's a sign of another condition that should be treated first or concurrently.
Should I be concerned about anal skin tags or scarring?
For some people, anal skin tags are simply a cosmetic concern. For others, they can have a genuine impact on everyday life.
Depending on the individual, they may:
Make hygiene more difficult (after bowel motions)
Cause irritation or rubbing
Become uncomfortable during exercise
Affect confidence or body image
Cause discomfort during receptive anal intercourse
These concerns are entirely valid, even when the underlying condition is medically benign.
For people who engage in receptive anal intercourse, the anus is not only a functional part of the body but also an important aspect of intimacy and sexual wellbeing. Changes in appearance, scarring or sensation can affect confidence and comfort during sex, yet these conversations are often overlooked during medical consultations. In a study conducted by Dr Matt Marino of gay and bisexual men who had undergone anorectal surgery, 50% were concerned about post-operative scars and appearance, 30% developed skin tags after surgery which affected the ability to have receptive anal intercourse in half. You can read the original study here.
Dr Matt Marino has a particular interest in managing anorectal conditions that affect sexual wellbeing, including for LGBTQIA+ patients. His approach considers not only symptom relief, long-term function and the individual priorities of each patient.
Can anal skin tags be removed?
In many cases, yes. Treatment isn't always about simply removing excess skin but should address the underlying problem to achieve the best possible long-term outcome.
Depending on the cause, treatment may include:
Observation if the skin tag is healthy and not causing problems
Treating an underlying fissure or haemorrhoid first
Removal of simple skin tags in the office (this can be combined with other minor procedures)
Surgical management in selected situations, especially if the skin tag is broad-based or would require haemorrhoid removal as well
The most appropriate option depends on your symptoms, the underlying cause, the ‘anatomy’ of the skin tag and your goals for treatment. Removal in the operating theatre can also be done concurrently with other procedures, such as colonoscopy.
Why isn't surgery always the answer?
Although removing a skin tag may sound straightforward, every procedure creates another wound that needs to heal.
This means surgery can sometimes result in:
Further scar tissue
Dissatisfaction over the cosmetic result
Delayed healing
Changes in sensation
New skin tags
Ongoing or recurrent symptoms
All surgeries carry possible risks, and whilst skin tag removal is usually minor, complications such as infections and bleeding are possible. This is why treatment decisions should be carefully considered and individualised.
For some patients, the best outcome comes from removing the skin tag. For others, treating the underlying condition or choosing not to operate at all, may provide a better long-term result.
When should I seek advice?
It's worth arranging an assessment if you:
Have persistent skin tags or scarring that concern you
Find hygiene difficult
Experience discomfort during intimacy
Have ongoing pain or irritation
Are unsure whether the changes you're noticing are normal
A specialist assessment can determine whether treatment is appropriate, identify any underlying conditions, and discuss the benefits and risks of the available options.
How we can help
Changes in appearance after haemorrhoids, fissures or anorectal surgery are common, but they don't have to be something you simply live with. Whether your concerns relate to comfort, hygiene, confidence or sexual wellbeing, Dr Matt Marino provides personalised assessment and treatment focused on preserving function while achieving the best possible long-term outcome.
If you're concerned about anal skin tags, scarring or changes in appearance, speak with your GP or healthcare provider about the options available. If you would like to arrange a consultation with Dr Marino, contact us here or call on 0493 318 188 to book an appointment.
